CBT for Sz Flashcards
What is the CBT used for Sz
CBTp (Cognitive Behavioural Therapy for Psychosis)
How many sessions are recommended for people with Sz
NICE recommend at least 16 sessions
What is the aim of CBTp
To help people establish links between their thoughts, feelings or actions and their symptoms and general level of functioning. By monitoring thoughts, feelings or behaviours with respect to their symptoms, patients are able to consider alternative ways of explaining why they feel and behave the way that they do
What might clients be encouraged to do in CBTp
- Trace the origins of their symptoms to get a better idea of how they might have developed
-Evaluate the content of their delusions or of any voices, and consider ways they might test their faulty beliefs
-Might be set behaviour assignments so they can improve their general level of functioning
Why might someone with Sz have learned maldaptive responses to life’s problems
Because of their distorted thinking by making mistakes when assessing cause and effect. During CBT the therapist allows the patient to develop their own alternatives to these maldaptive beliefs, ideally looking for alternative explinations and coping strategies that are already present in the patients mind
What are the stages of CBTp
Assessment
Engagement
The ABC model
Normalisation
Critical Collaborative Analysis
Developing Alternative Explinations
What happens during the ABC model of CBTp
The patient gives their expination of the activating events that appear to cause their emotional and behavioural consequences. The patients own beliefs can then be rationalised, disputed and changed
What happens during the normalisation part of CBTp
Telling the patient that many people have experiences like halluinations or delusions can relieve anxiety in the patient and also a sense of isolation. This makes the possibility of recovery seem more likely
What is critical collaborative analysis
The therapist uses gentle questioning to help the patient understand illogiccal deductions and conclusions. This can be done without causing distress so long as there is trust between the two and the therapist remains empathetic and non-judgemental
What are some avantages of CBTp over normal care (eval)
A NICE (National Institute for Health and Care Excellence) review of treatments for Sz found consistently that compared to antipsychotics alone CBTp was effective in reducing rehospitalisation rates up to 18 months after the end of treatment. It has also been shown to reduce symptom severity and compared to antipsychotics, improves social functioning
What is an issue with studies into the effectiveness of CBTp
Most studies are done with patients treated at the same time as antipsychotics, so it is difficult to assess the effectiveness independently
Who did a review of CBTp vs drugs
NICE (National Institute for Health and Care Excellence)
Why is the availability of CBTp an issue (eval)
Despite being recommended as a treatment by NICE, CBTp is only accessed by 1 in 10 people in the UK who could benefit from it. There are regional differences, with a survey by Haddock et al finding that in the North West, only 13 of the 187 randomly selected patients had been offered CBTp. This could be as a significant portion of those who it is offered to either refuse or fail to attend sessions
Who did a survey of CBTp care in the North West
Haddock et al
Why might the effects of CBTp have been overstated (eval)
Recent large scale meta-analysis of CBTp as a sole method of treatement by Jauhar et al revealed only a small therapeutic effect on key symptoms, such as hallucinations. Even these small effects dissappeared when symptoms were assessed ‘blind’. This uncertainty over the best treatment has led to confliciting recommendations within the UK, where Scotland emphasises drugs while England and Wales emphasis CBTp
Who conducted a recent large scale analysis of CBTp as a sole method of treatment
Jauhar et al
